Exam 4: Bipolar Flashcards
Manic Episode
dramatic and inappropriate rises and mood out of proportion to the actual happenings in someone’s life; can be happy and euphoric or irritable and angry
Hypomanic Episode
less severe symptoms of mania that cause little impairment, changed mood for at least 3 days, uncharaceristic of normal personality, observable by others
Diagnosis
3 or more symptoms (4 for irritability) during manic episode: inflated self esteem/grandiosity, decreased need for sleep, more talkatibe, flight of ideas, distractability, increased activity/agitation, excessive involvement in activities; marked impairment in functioning, or necessary hospitaization to self/others
Bipolar I
at least 1 manic episode, may be hypomanic, almost always a major depressive episode
Bipolar II
at least 1 depressive episode, at least 1 hypomanic episode, no manic episode
Cyclothymic Disorder
frequent mild depression and frequent hypomania; symptoms at least half of the time for at least 1 years (adults) or 1 year (children/adolescents)
Age of Onset
average adolescence/early adulthood, diagnosis between 15-44
Bipolar I: 18
Bipolar II: 19-22
Prevalence: Lifetime Bipolar
up to 4% (less common than depression)
Prevalence: Lifetime Cyclothymic
.4-1%
Prevalence: 1 yr. Bipolar I
.6%
Prevalence: 1 yr. Bipolar II
.8%
Gender Patterns
m = f, but first episode is more likely depression in females and mania in males, females more likely to have depressie episodes and cycle more rapidly through episodes
Comorbidity (Bipolar I and II)
substance abuse, eating disorders, ADHD, panic disorder, social anxiety, higher suicide rates, bipolar II: BPD
Bipolar in Children
often used as catch-all category for aggressive kids (disruptive mood dysregulation disorder has become a more common diagnosis), over-diagnosis caused overmedication with meds not tested in kids
Psychodynamic Theory
mania as a defense against depression and low self esteem
Biological Theory: Neurotransmitters
norepinephrine/serotonin overactivity or difference in receptors; seems to be associated with less serotonin but neurotransmitter role is unclear and generally unsupported
Biological Theory: Sodium Ion Instability and Membrane Permeability
Lithium (blood salt) as major treatment effective in moderating mood swings and regulating bipolar and MDD; theory suggests that Na+ does not properly flow in and out of membrane properly during action potential; now a revised hypothesis including calcium; membrane permeability problems including Protein Kinase C
Biological Theory: Genetics
higher heritability in bipolar than depression but does not completely account; twins: MZ 70% DZ 30% (larger gap between MZ and DZ); 25% first degree relatives have mood disorder (usually depression)
